CMS meets MIPS reporting goals, but thousands of doctors still face penalties

More than 90% of clinicians required to report under MIPS submitted data this year, but thousands of physicians will still face penalties for not complying with the program, according to CMS Administrator Seema Verma.

The CMS found that 91% of clinicians eligible to participate in the Merit-based Incentive Payment System submitted data in the program's first year, surpassing the agency's goal of 90% participation, Verma announced in a blog post Thursday.

The agency will use MIPS performance data to adjust providers' Medicare reimbursement starting Jan. 1, 2019. Data for the first year of MIPS was due April 3. Under the program, physicians can earn a 4% increase or cut to their reimbursement.

Physicians' pay under MIPS is based on their success in four performance categories: quality, resource use, clinical practice improvement and "advancing care information" through use of health information technology. The advancing care criteria is based on the government's meaningful use program, which determines whether doctors are rewarded for using EHRs.

Between alternative payment models and small practice exemptions, only 39%, or around 621,700 of the 1.5 million clinicians now billing under Medicare are eligible to report under MIPS.

Based on those estimates, roughly 55,000 did not submit data to the agency and face a 4% cut in Medicare reimbursement. Last year, the agency let doctors pick their own pace to submit 90 days' worth of data. Starting in 2018, doctors will need to supply the agency with a full year's worth of information.

Some providers were worried last year that they would not be able to meet MIPS deadlines due to technical difficulties and lack of information on program requirements.

The agency hopes MIPS providers will eventually hit a 100% reporting rate, and it is looking to reduce regulatory burden.

"Even with this high rate of participation, we are committed to removing more of the regulatory burdens that get in the way of doctors and other clinicians spending time with their patients," Verma said in the post.

An edited version of this story can also be found in Modern Healthcare's June 4 print edition.